BRANDON WALLACE GODFREY (NPI# 1629495833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629495833 |
| Entity Type | Individual |
| Full Name | BRANDON WALLACE GODFREY |
| Credential | M.D. |
| Practice Address |
4700 Las Vegas Blvd N Nellis Afb NV 89191-6600 |
| Mailing Address |
1625 N Campbell Ave Tucson AZ 85719-4330 |
| Practice Telephone | 7026533426 |
| Mailing Telephone | 7026533426 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2019-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 51008 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
4700 LAS VEGAS BLVD N |
| City | NELLIS AFB |
| State | NV |
| Zip Code | 89191-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445389 | Frank J Andriola | Internal Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2005-05-23 |
| 1245837392 | Cameron Springer | Military Health Care Provider | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-10-01 |
| 1063026474 | Haley Suzanne Emery | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-09-02 |
| 1033729991 | Brock Shaw | Dentist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-08-05 |
| 1801404397 | Madelyn Danielle Golden | Military Health Care Provider | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-07-21 |
| 1114544103 | Jami Myong Reece | Family Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-25 |
| 1225654296 | Leah Corr | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-24 |
| 1821614405 | Aubrey Amanda Blanchette | Student in an Organized Health Care Education/Training Program | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-19 |
| 1346866290 | Shelbi Diane Duncan | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-17 |
| 1235751538 | Howard Luong | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225662687 | Ashley Raye Roth-garcia | Student in an Organized Health Care Education/Training Program | 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 | 2020-02-25 |
| 1427553734 | Christopher Robert Weisgarber | Student in an Organized Health Care Education/Training Program | Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 | 2018-03-28 |
| 1912345448 | Austin Joseph Ladner | Dentist | 99th Air Base Wing Public Affairs, Fpo, AA 89191 | 2013-06-06 |
| 1528329018 | Mayer M Jeppson | Psychologist | 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 | 2012-05-31 |
| 1255560462 | Jordan Lawrence | Military Health Care Provider | 1579 Malmstrom Avenue, Nellis Afb, NV 89191 | 2009-07-09 |
| 1225263072 | Adrienne L Clark | Military Health Care Provider | 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 | 2009-05-22 |
| 1568634335 | Eleanor C Basilio | Registered Nurse | 4700 Las Vegas Blvd., Nellis Afb, NV 89191 | 2008-04-01 |
| 1316137037 | Sarah Rachel Glick | Pediatrics | 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 | 2007-07-30 |
| 1619181302 | Ben Carter Robinson | Orthopaedic Surgery | 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 | 2007-05-10 |
| 1609992205 | Conrad Lochner IIi, Odpc | Optometrist | 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 | 2007-03-22 |
| Find all providers in zip 89191 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861924458 | Jeremy L. Brenneman | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2017-04-01 |
| 1710349857 | Eric W Maughan | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2016-03-28 |
| 1528420890 | Samuel W Bergin | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2016-03-24 |
| 1134589559 | Frederick P Griffith Iv | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2016-02-26 |
| 1922493758 | Elizabeth Ph Chen | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 | 2015-03-30 |
| 1922492875 | Peter J Malamet | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2015-03-27 |
| 1265825541 | Alexander Pingree | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2015-03-11 |
| 1811317860 | Mackenzie Gabler | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2014-04-17 |
| 1780001818 | Schon C Roberts | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2014-03-26 |
| 1376968552 | Eugene Kang | Emergency Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89181 | 2014-02-25 |
| Find all providers in NELLIS AFB | ||||
| City | NELLIS AFB |
| Zip Code | 89191 |
Please comment or provide details below to improve the information on BRANDON WALLACE GODFREY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.